Background
The aim of the study was to conduct a comprehensive functional and radiological follow-up assessment in patients at least 10 years after adductor magnus MPFL reconstruction, and to assess the presence of early degenerative changes.
Methods
The mean age at the time of surgery was 16 years (range: 8 to 18 years, SD 2.5). The follow-up examination was performed at least 10 years following adductor magnus MPFL reconstruction (mean 11 years). Twenty-one patients (26 operated knees) attended the follow-up. The mean age at follow-up was 25.1 years (range 20–29 years).
Results
The significant improvement observed at 3 years, indicated by the Kujala and Lysholm scores, was maintained after 10 years of follow-up (p < 0.001). A single recurrence of dislocation was noted in three patients. A significant improvement in radiological parameters was noted. No significant difference in the incidence of chondromalacia, of any degree, was observed compared to controls.
Significantly higher quadriceps peak torque was noted for both angular velocities (60 and 180°/sec) compared to the preoperative readings (p < 0.001). Knee flexors were found to be significantly stronger at both 60 and 180°/sec at 10 years follow-up examination (p = 0.008 and p < 0.001 respectively).
Conclusion
The use of MPFL reconstruction according to Avikainen yields improvements in clinical and radiological results which are maintained throughout the observation period. No significantly greater articular cartilage degeneration was noted in patients after surgical treatment for recurrent patellar dislocation compared to healthy peers.
Trial registration
Registered on Clinical Trails.gov with ID: PMMHRI-BCO.67/2021-A.
Late diagnosis and treatment of septic arthritis (SA) after anterior cruciate ligament reconstruction (ACL-R) can lead to graft and cartilage damage. Pathogen eradication time may be the key to preventing the development of osteoarthritis. The purpose of this study was to evaluate the effect of the proposed management of SA after ACL-R on knee function, pathogen eradication time and knee cartilage status on MRI. Five patients with acute knee SA after ACL-R were included in this study. All five patients underwent knee arthroscopic debridement with lavage and flow drainage with physiological saline with vancomycin. All five patients underwent clinical assessment, isokinetic examinations and MRI quantitative cartilage thickness evaluation at two follow-up points: at a mean of 10.9 years and at a mean of 18.1 years. Slight statistical differences in cartilage thickness on the medial femoral condyle were observed between the SA and control groups (2.077 mm and 2.237 mm, respectively; p = 0.021). There were no significant differences in cartilage thickness between the first and last follow-ups in the SA knees. The proposed treatment could lead to a faster eradication of infection, and thus protect against the early development of osteoarthritis. The quadriceps peak torque deficit may persist afterwards at a mean of 18.1 years follow-up.
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